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Solution to nursing shortage will not come overnight

It may have been easier for the Mississippi Hospital Association (MHA) to list what staff positions and areas of the state were not experiencing nursing shortages, rather than the other way around.

In the last year, hospitals across Mississippi have experienced increased difficulty recruiting and retaining registered nurses. Vacancy rates for RNs in hospitals are 9.5% statewide, reflecting a rate that has doubled in the last 12 months. Vacancy rates range from 4% to more than 20% depending on the area of the state. According to the MHA, hospitals are finding it difficult to recruit nurses for staff nurse positions, particularly in critical care areas, medical surgical units, labor and delivery and emergency rooms. The list of areas with nursing shortages across the state includes metro Jackson, the Delta and Northwest Mississippi where Mississippi hospitals compete for personnel with the Memphis market.

“In response to the increasing nursing shortage in Mississippi, hospitals have escalated efforts to recruit nurses by advertising aggressively in print, television and radio,” said Marcella McKay, MHA vice president for nursing and professional affairs. “Incentive packages include increased compensation and enhanced benefits, flexible scheduling, sign-on bonuses, retention bonuses, on-site childcare and other job-related benefits.”

Hospitals are also working with area nursing schools to encourage students to enroll in healthcare programs. And in some areas of the state, schools and hospitals are jointly advertising to recruit students into nursing.

Hinds Community College is one such school working with hospitals around the state to increase the number of RN’s and licensed practical nurses currently available. In spring 2001 Central Mississippi Medical Center, River Oaks Healthcare Systems, Rankin Medical Center, Baptist Medical Center, St. Dominic’s Hospital System, River Region Medical Center in Vicksburg and Mississippi State Hospital came together with Hinds Community College to begin the Workforce Enhancement Project (WEP). These groups have already launched a comprehensive media campaign to increase awareness and education about the need for nursing and allied health professionals.

Gloria Coxwell, dean of the associate degree (AD) nursing program at HCC, said the addition of a workforce enhancement project manager and proactive faculty are the major factors for HCC’s recent success of a now skyrocketing first semester enrollment in HCC’s AD nursing program. In the spring of 2001, HCC had 90 students enrolled in the program. In spring of 2002 there were 108 applicants. This month, the entering class is beginning at full capacity with 120 students. A waiting list has begun and eligible applicants who are not admitted in the fall will begin in January.

No quick fix

“Our goal is not a quick fix but to allow for a consistent feed into the market,” said Kathryn Cole, HCC WEP director. “The important thing is to not stop our enrollment and emphasis on education.”

Although people should start to see the fruits of HCC’s labor within about two years of WEP’s start, HCC’s efforts will not decrease anytime in the near future.

“We’re still in dire need of more nurses,” Coxwell said. “We’re doing what we can to try to increase the numbers here, but we’re not going to be able to meet the entire need.”

Wanda Jones, executive director of the Office of Nursing Workforce, said the typical cycle of supply and demand is usually a few years of a nurse shortage, followed by a surplus. This shortage, however, is expected to last about 20 years.

Kim Hoover, Ph.D., RN, is the data consultant for the Office of Nursing Workforce and associate professor at the Alcorn State University School of Nursing. She said 28,518 have active RN licenses in Mississippi. The number of nurses who are actively employed in the state, however, is decreasing. And the number of nurses who take their state board examinations each year is also decreasing.

One troubling figure, according to Hoover, is the number of RNs seeking licensure in other states and countries, which increased from 2,000 to 5,359 in 2001.

“That doesn’t mean they’re not also working in Mississippi or keeping their licenses active in Mississippi, but it does mean they’re going elsewhere,” Hoover said.

While things may look bad for Mississippi, the state may be better off than other places nationwide. Jones said nationally the shortage started around 1996 or 1997, but Mississippi’s shortage did not hit until last year.

No matter the locale, by the year 2020 it is predicted there will be a 20% shortage in the number of nurses needed in the U.S. healthcare system, which translates into an unprecedented shortage of more than 400,000 RNs according to an article in the Journal of the American Medical Association.

Dr. Barbara Rogers, interim dean for the School of Nursing at the University of Mississippi Medical Center, said part of this has to do with the fact that the workforce is aging and that the average age of nurses is increasing at more than twice the rate of other occupations. But, the growing nursing shortage is also due to the changing composition of the workforce.

“Ultimately, we have to attract people earlier,” Rogers said. “We have to make the work environment so that nurses will stay. We need to make sure the educational systems can support students both financially and intellectually and when they graduate we need to be sure they can go to a work environment that’s conducive to holding them — and that’s not an easy thing.”

Rogers sees nurses as the foundation for the healthcare system.

“When I think of nursing I think of the studs and girders that hold a building up,” Rogers said. “Nurses really are that for the healthcare system. When you build a house you have to have boards every so often to carry the weight of the roof. Take too much out and everything caves in. If you lose enough nurses out of the healthcare system it will crash just like a house will, and I think that’s the threat we’re in.”

However, the likelihood of realizing that threat is some ways away and Rogers has some hope for what the future holds.

“Our recruitment into the school of nursing this year is up a bit,” Rogers said. “I was recently at a dean’s meeting and most everyone there had seen a bit of an upsurge in their enrollment. I think that’s a positive thing. The other positive thing is that hospitals are beginning to look at the environment they’re practicing in. It’s not a hopeless situation — it’s just going to take some time and it’s going to take a long time. It’s not going to be a shot in the arm like an immunization.”

Contact MBJ staff writer Elizabeth Kirkland at ekirkland@msbusiness.com or (601) 364-1042.

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